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THE ROLE OF THE FAMILY DOCTOR
In
Public Health
And
Emergency Preparedness
A Discussion Paper
December 2005
National Office/Siège Social
2630 avenue Skymark Avenue
Mississauga, Ontario, L4W 5A4
1.800.387.6197
fax 905.629.0893
www.cfpc.ca
Role_Fam_Doc_Dec05.indd 1
11/29/05 12:48:01 PM
The Role of the Family Doctor
In
Public Health
And
Emergency Preparedness
A Discussion Paper
December 2005
CONTENTS
Public Health, Primary Care, and Family Medicine
p. 3
Increasing Emphasis on Public Health
p. 3
The Roles of Family Doctors in Public Health
p. 6
Family Doctors and Public Health Emergencies
p. 8
What do Canadians Say About Family Doctors in Public Health Emergencies?
p. 9
What do Family Doctors Say About Resources Needed During Public Health
Emergencies?
p. 10
Recommendations
p. 11
Endnotes
p. 14
Appendix A
p. 15
Appendix B
p. 17
Contacts
p. 18
The College of Family Physicians of Canada
The Role of the Family Doctor in Public Health and Emergency Preparedness
December 2005
1
“The challenge we face today is extraordinarily complex; an unprecedented task of
emergency preparedness and response…
Experience with SARS has taught many of us some vital lessons…
The first is the importance of working with the best information available, and sharing
it effectively. Second is the importance of swift coordinated action – among different
orders of government, health officials and first responders – guided by a detailed plan
that everyone can work from… The more quickly we can report on the risks, the
more quickly we can act, the better for all of us.”
-
Prime Minister Paul Martin
Meeting of Ministers of Health on Global Pandemic Influenza Readiness1
“Organizations such as ‘integrated health systems,’ with their orientation towards
primary care, are now assuming responsibility for the care of populations, heretofore
the defining characteristics of public health…”
“Countries oriented toward a strong primary care infrastructure achieve better health
outcomes…mortality, morbidity…and preventive healthcare.”
-
Dr. Barbara Starfield
American Journal of Public Health2
The College of Family Physicians of Canada
The Role of the Family Doctor in Public Health and Emergency Preparedness
December 2005
2
Public Health, Primary Care and Family Medicine
According to the Dictionary of Epidemiology, public health is described as: “The science
and art of preventing disease, prolonging life and promoting health through the organized
efforts of society.”
This discussion paper examines the role of family medicine and family doctors in public
health, including the part played by family doctors in health promotion, disease
prevention, chronic disease management and, in particular, in preparing for and managing
public health emergencies. In Canada, family doctors are the main providers of primary
medical care and in the event of a public health emergency, are therefore integral to the
timely delivery of critical medical services
This paper looks at the value that family doctors can and do contribute to public health.
It is about the benefits of managing the interface between primary care and public health.
But it is more than that. It is also about being ready for public health emergencies of
such national severity and global importance that they could threaten the delivery of
all other health care and social services in Canada.
What should be done to prepare? In this report, The College of Family Physicians of
Canada (CFPC) outlines the issues that need to be addressed to ensure that: (i) Canadians
will have the help they require if faced with another public health crisis, and; (ii) family
doctors will be adequately prepared to meet their patients’ expectations during a public
health emergency. There is no certainty about if or when such a crisis might occur. But
we would be foolish not to prepare. Primary care/family medicine and public health must
therefore work together to address the gaps in services that currently exist, gaps that
could leave us unprepared to handle a public health emergency. The CFPC believes that
better collaboration and cooperation between family doctors and those providing public
health services will ensure the best possible outcomes under these extraordinary
circumstances.
As part of this report, the results of the October 2005 Decima public poll commissioned
by the CFPC and a poll of family doctors conducted by the CFPC are both being
released. These surveys asked Canadians how important family doctors are to them
during a public health emergency, e.g. a serious infectious disease outbreak or natural
disaster, and how confident Canada’s family doctors are in the readiness of the health
care system to support them in caring for their patients during such an emergency.
Increasing Emphasis on Public Health
Over 200 years ago, disease prevention was achieved largely through quarantine with
little understanding about how diseases were first contracted, then transmitted. During
the 19th century, reducing incidences of disease was linked to improved hygiene and
The College of Family Physicians of Canada
The Role of the Family Doctor in Public Health and Emergency Preparedness
December 2005
3
sanitation. Strict isolation of disease-stricken patients was no longer viewed as the most
humane or the only way of preventing and reducing the spread of disease. In fact, it was
acknowledged that health care was no longer the burden of the individual but that all of
society had a role in safeguarding the health of the public.
As society moved toward urbanization, governments implemented further measures to
improve public health. Today, about 80 per cent of Canadians live in urban centres and
coupled with faster modes of global travel, urban centres are particularly susceptible to
the rapid spread of disease.
As public health evolves and gains more attention, Canadians are increasingly aware of
issues related to illness or injury prevention and health promotion. Activities related to
smoking cessation, healthy eating, weight control, physical activity and managing
substance abuse are given greater attention in the media. Chronic disease prevention has
taken on increasing importance with more focus on how to prevent and provide better
care for such illnesses as diabetes, hypertension, asthma, strokes, and coronary artery
disease. As expectations for management of these conditions has grown, more attention
has also been paid to cost-effective and evidence-based care. All of this requires a public
health system that includes medical and other health care leaders and providers working
together in the community.
As the Canadian public becomes more attuned to public health issues, it should be
acknowledged that family doctors have long been both leaders and providers of care in
four key areas of public health:
•
•
•
•
Health Promotion: Family doctors advocate for public health policies and
provide advice and care for individuals and families aimed to improve their health
and wellbeing. Family medicine and health promotion are both focused on caring
for the whole person.
Disease and injury prevention: Counseling and screening for acute and chronic
diseases are integral to the role of family doctors. Disease and injury prevention
are woven throughout the ongoing care provided for patients throughout their
lives by their family doctors.
Chronic Disease Management: Diagnosis, treatment and prevention of
complications (secondary prevention) related to chronic diseases have always
been a major part of the role of family doctors. With shifts of care from hospitals
to home, the responsibilities of community-based health professionals, including
and often led by family doctors, has been growing dramatically.
Health Surveillance: As primary medical care providers, family doctors care for
and report suspected or confirmed infectious diseases that threaten the health of
their patients and the populations in which their patients reside. By identifying
outbreaks through screening, diagnosis and reporting, family doctors play a major
role in helping to reduce the severity of outbreaks.
Over the last few years, Canadians – and our governments and health care professionals –
have been impacted significantly by a host of infections, such as West Nile Virus, toxic
The College of Family Physicians of Canada
The Role of the Family Doctor in Public Health and Emergency Preparedness
December 2005
4
E. coli in drinking water, institutional outbreaks of clostridium difficile, Legionnaire’s
Disease, and of course SARS (sudden acute respiratory syndrome) that have created
major public health challenges. Now there are growing concerns about the potential for
another great flu pandemic related to H5N1 (avian influenza) or other infectious or
biological threats – diseases that could jeopardize the health of large populations.
In addition to the potential of disease outbreaks, recent natural disasters such as the
tsunami in East Asia, the earthquake in Pakistan and India, the mudslides in Guatemala
and Mexico, and Hurricane Katrina in New Orleans, have served to remind Canadians of
the threat of natural disasters within our own borders – and the need to be prepared.
In an increasingly global environment, a wait-and-see approach is no longer acceptable.
Canadians everywhere, whether in cities or in our rural or remote communities, expect a
timely response to public health issues. The number of Canadians that could be affected
by public health emergencies has grown exponentially; sophisticated medical and
information technology have augmented the expectations of Canadians regarding the
performance of our health care system; and, the challenges of maintaining and funding
our health and social welfare systems have become increasingly complex.
In light of these concerns, Federal/Provincial/Territorial (FPT) governments have
undertaken some significant initiatives related to public health:
•
•
•
•
•
While the First Ministers’ Accord of February 2003 was relatively devoid of
reference to public health, their Agreement of September 2004, driven by post
SARS public outcry and the Naylor Report, recognized the importance of public
health. In their report, First Ministers expanded the support for public health to
include health promotion, disease and injury prevention, and chronic disease
prevention management.
Dr. Carolyn Bennett was appointed Minister of State (Public Health) in December
2003. This was followed in 2004 by a number of significant organizational
achievements in the public health system, including the establishment of the
Public Health Agency of Canada and the appointment of Canada’s first Chief
Public Health Officer, Dr. David Butler-Jones, also a family doctor.
Recognizing progress and the creation of the Public Health Agency, First
Ministers in September 2004 also committed to the development of a Public
Health Network that would coordinate responses to infectious disease outbreaks
and other public health emergencies.
In addition, First Ministers committed to accelerate work on a Pan-Canadian
Public Health Strategy (later referred to as the Canadian Healthy Living Strategy)
to address common risk factors such as physical inactivity and obesity. FPT
governments are working across sectors in promoting initiatives such as Healthy
Schools.
FPT governments are putting the National Immunization Strategy into action.
The Canadian Immunization Committee has been established to ensure these
goals are achieved with appropriate stakeholder input.
The College of Family Physicians of Canada
The Role of the Family Doctor in Public Health and Emergency Preparedness
December 2005
5
•
•
The federal budget (March 2005) committed $34 million over five years toward
pandemic influenza preparedness.
In October 2005, FPT Health Ministers referred a list of recommended Public
Health Goals (now Canada’s Health Goals) to First Ministers. These goals were
developed through a series of consultations led by federal Minister of State
(Public Health), Dr. Carolyn Bennett, and Manitoba’s Minister of Healthy Living,
Ms. Theresa Oswald.
The Roles of Family Doctors in Public Health
A poll recently commissioned by the CFPC found that 88 percent of Canadians believe
having a family doctor allows them to feel confident in their ability to access appropriate
and timely care in the health system.3 In addition, when Canadians have a family doctor,
they give the health system a much higher quality rating (Canadian Medical Association
National Report Cards 2003 and 2005).4
For family doctors, incorporating public health into practice has always been important in
diagnosing, treating and caring for their patients. Integral to their medical practices,
family doctors counsel patients on the prevention of injuries and illness, assess the health
status of their practice populations, and promote healthy living. And while more recent
terms such as chronic disease management may not have been widely used in the past,
preventing, diagnosing and treating mental health, diabetes, hypertension, arthritis,
stroke, heart disease and other chronic diseases, have long constituted a significant
portion of everyday family practice. Family doctors across Canada have also played key
roles in disease surveillance and treatment during times of infectious outbreak, including
promoting better health and screening for these diseases. The value of family doctors in our
evolving public health system is potentially immense. But to date, it has not gained the
attention or the support it deserves.
What family doctors do is core to the definition and objectives of public health. While
public health focuses on prevention and treatment for populations and the broader
community, family medicine focuses on the health and wellbeing of the individuals and
families that make up these populations and communities. The practices of family doctors
in managing and treating individuals is inextricably linked to the goals that must be
achieved by our public health system.
In addition to providing acute and continuing care for each of their patients, family
doctors also contribute to public health care by:
• Acting as advisors in developing public health programs
• Delivering public health programs as a resource to a patient population
• Participating in screening and prevention programs
• Applying population-based indicators to their practice populations
• Implementing patient counselling programs for special public health needs
• Supporting patient participation and self-help in public health education, e.g.
healthful eating and physical activity
The College of Family Physicians of Canada
The Role of the Family Doctor in Public Health and Emergency Preparedness
December 2005
6
•
•
Working with public health nurses in family practice settings, complementing
one another in delivering health services
Collaborating with public health officials in disease outbreaks and follow-up
research initiatives
In its November 2004 policy paper, Family Medicine in Canada – Vision for the
Future, the CFPC emphasized that an effective public health system must
recognize and support an enhanced role for family doctors, requiring at least the
following5:
•
•
•
•
•
Governments, medical schools, and professional colleges to ensure that
family physicians have the opportunity to acquire the knowledge and skills
they need to deal with public health issues and crises
Public health officials, hospitals, and regional health authorities to work
collaboratively with family physicians in managing and effectively
containing population-based outbreaks
Appropriate and timely communications supported by up-to-date
information and communication networks linking public health authorities
and offices with family doctors in our communities across Canada
Supplies, distribution systems, and other supports for office practices
Support to carry out disease surveillance and ongoing research related to
community-based public health issues
In addition to the above the CFPC also recommends:
• The health care system should augment the roles for and recognition of family
doctors working together with other health care professionals in disease
prevention and surveillance, health promotion, chronic disease screening and
prevention and other aspects of importance to public health.
• Governments, medical schools and professional organizations should support
undergraduate and postgraduate education, training, and continuing medical
education / professional development for family doctors in areas related to their
roles in public health.
• The CFPC should collaborate with the Public Health Agency of Canada (PHAC)
and the Canadian Public Health Association (CPHA) to examine the roles of
family doctors in public health. Consideration should be given to the creation of a
joint task force building on the objectives of the PHAC’s Centres for Chronic
Disease Prevention and Control, Infectious Disease Prevention and Control, and
Surveillance Coordination.
The College of Family Physicians of Canada
The Role of the Family Doctor in Public Health and Emergency Preparedness
December 2005
7
Family Doctors and Public Health Emergencies
In the event of a public health emergency, Canadians must be assured that they will be
able to access health care professionals, including family doctors. Assurance that Canada
is prepared to handle public health emergencies will only come with the knowledge that
public health is appropriately integrated with family medicine.
Throughout public health crises such as the E. coli infections in Walkerton and the SARS
outbreak in Toronto, family doctors and other primary health care professionals were on
the front lines caring for patients. Historically, during public health emergencies, family
doctors are often the first to be called upon to provide and coordinate medical care and to
help limit the impact of communicable diseases and outbreaks in their practice
populations.
An important barrier to integration and delivery of needed public health services is the
shortage of family doctors and other health professionals. For Canadians, concerns about
shortages are not just about access
to one’s own family doctor – they
“I am already working at maximum potential
are also about a health care system
day-to-day. I have no idea how I or my office
that is strained beyond its
capacity – even during times where could handle the additional load of a major
influenza outbreak.”
the demands are not out of the
ordinary. In times of crisis the
- Family Physician Poll Respondent
shortage of front-line providers,
including family doctors, will
significantly compromise the
ability of the system to respond. Hopefully, recent critical public health experiences will
help motivate our system planners to support increases in the numbers of family doctors
and introduction of better supports for the collaborative role of family doctors as part of
the public health system.
In Canada it is estimated that over 80% of the population or over 25 million people have
family doctors to whom they turn first for most of their medical care. Being the first line
care provider for these patients places family doctors in a central and critically important
position in community health care. But family doctors are often frustrated in their roles
and responsibilities because of inadequate connectivity to other parts of the system and
insufficient supports in the delivery of care. The question of public health system
integration and collaboration should be addressed by supporting family doctors who act
as leaders and key resources to their peers and other primary care providers in preparing
for and implementing emergency responses.
In order to improve the links between public health and primary medical care/family
medicine:
•
It is imperative that governments and health leaders work towards breaking down
the silos of primary care and public health to ensure adequate, coordinated
The College of Family Physicians of Canada
The Role of the Family Doctor in Public Health and Emergency Preparedness
December 2005
8
•
•
emergency responses in which family doctors and other health professionals have
the confidence and ability to handle public health emergencies.
Public health officials, hospitals and other health authorities should collaborate
with family doctors in developing supportive local communications networks in
primary and other care levels to manage population-based public health
emergencies.
Community family practices must be provided with the resources, including
funding, support staff, information and materials needed to support the roles of
family doctors and other primary care providers responding to community public
health crises and emergencies.
There are many lessons learned from a variety of public health emergencies in recent
months and years. One of the most important came from the international responses to
the tsunami in East Asia. While numerous efforts were made to provide the resources
required by such a large number of deprived people, there were many challenges. The
best intentions – demonstrated by the international outpouring of aid to victims of the
tsunami – were hampered not by a lack of aid, but by poor planning and coordination.
Even though much of the planning for public health emergencies currently happens
within public health, primary care providers, including family doctors, should be engaged
in the planning process. The degree of cooperation between public health and family
doctors in the development of an emergency plan will be a key determinant for its
success when Canadians are faced with a real public health emergency.
What do Canadians Say About Family Doctors in Public Health Emergencies?
In October 2005, a Decima poll commissioned by the CFPC surveyed the Canadian
public (see Appendix A for complete polling data). Canadians were polled on the level
of importance they attached to emergency planning, the roles of their family doctors in
working with public health, and their confidence in the readiness of the health care
system to deal with a national or regional public health emergency.
The Decima poll clearly indicates that Canadians expect their family doctors to be
working with public health officials, specifically during a public health emergency. An
overwhelming majority (86%) said it’s important at a time of serious medical emergency
– such as a widespread influenza outbreak or natural disaster – that they are able to turn
to their family doctor for information and advice. Almost every Canadian polled (96%)
said it’s important that family doctors have access to the information, equipment,
supplies, and other supports they would need in the event of a public health emergency.
And nearly every Canadian polled (93%) also agreed that primary care professionals
must be involved in the development of emergency plans for Canada because they are
sure to be on the frontlines in the event of a public health emergency. Results indicate
that a majority of Canadians value the integral roles that family doctors play in the
delivery of care related to public health. Of great importance however, 84% of Canadians
The College of Family Physicians of Canada
The Role of the Family Doctor in Public Health and Emergency Preparedness
December 2005
9
believe the shortage of family doctors could impact the ability of the health care system
to respond to the medical needs of Canadians during an emergency or natural disaster.
In addition:
• 68% of Canadians believe it is likely that a city or region in Canada could face a
serious medical emergency or a natural disaster in the next three years.
• 62% of Canadians do not believe governments are doing enough to ensure the
health care system is prepared to respond to an emergency or natural disaster.
What do Family Doctors Say About Resources Needed During Public Health
Emergencies?
An excellent barometer of Canada’s emergency preparedness can be found in how
confident our family doctors feel about the system’s ability to help them carry out their
roles in emergency situations, such as an influenza pandemic or natural disaster.
In October 2005, the CFPC polled family doctors about how well prepared they and their
practice environments are to deal with public health emergencies. (see Appendix B for
complete polling data). The results reveal that 71% of family doctors do not feel
sufficiently ready in their practices to handle a public health emergency such as a
pandemic influenza outbreak or a natural disaster. Two-thirds (65%) of family doctors
are also not confident that in the case
of a regional or national emergency,
“The infrastructure of hospitals and
e.g. flu outbreak or natural disaster,
emergency departments is completely
they will be able to get the
inadequate for dealing with a pandemic. The
information, equipment, supplies,
system has no surge capacity, so even if I
and personnel needed to provide the
personally was [sic] well supplied, I would
level of care their patients need.
not have the system backup required.”
If they had the information,
- Family Physician Poll Respondent
equipment, supplies and personnel
needed to help their patients, half of
the family doctors polled said they
would feel sufficiently supported to care for their patients during a pandemic flu outbreak
or a natural disaster. It is noteworthy that 31% still said that they didn’t know whether
the aforementioned materials would necessarily be enough to support them to care for
their patients. These results suggest that many family doctors feel that the necessary
resources will not likely be there when they need them. For those who experienced the
uncertainty and absence of support during the SARS outbreak, this lack of confidence in
the system is not hard to understand.
In addition:
• 85% of family doctors believe the shortage of family doctors will impact the
ability of the health care system to respond to the medical needs of Canadians
The College of Family Physicians of Canada
The Role of the Family Doctor in Public Health and Emergency Preparedness
December 2005
10
•
during a public health emergency. (Consistent with 84% of the public sharing this
same concern)
53% of family doctors do not think all levels of government are working well
together to ensure the health care system is prepared to respond to a public health
emergency.
Recommendations
In its paper Family Medicine in Canada – Vision for the Future (November 2004) the
CFPC made several recommendations related to the interaction and involvement of
family doctors in public health6. These are:
1. Family physicians should be recognized and provided with the education and
practice support needed to enable them to be an integral part of Canada’s public
health system.
2. Governments, public health systems, medical schools, and professional colleges
should support undergraduate and postgraduate education, training, and
CME/CPD for family physicians in areas related to their potential public health
roles.
3. Public health officials and hospitals should communicate and collaborate with
family physicians to manage population-based public health crises and
emergencies.
4. Community family practices must be provided with the resources, including
funding, support staff, information and materials (supplies), needed to carry out
their role in community public health crises and emergencies.
5. Electronic records to aid surveillance, monitoring, reporting, research, and
quality control should be developed and implemented to link networks of
community-based family physicians to public health officials.
In addition to the above, The College of Family Physicians of Canada recommends the
following to support the involvement of family doctors working with public health and to
ensure the most appropriate responses during a public health emergency:
1. Family doctors should be valued and recognized by all governments, health
authorities and primary / public health providers for their roles in public health
from disease prevention to health promotion, chronic disease management and
providing care during public health emergencies.
2. As governments, health authorities and other jurisdictions plan for public health
emergencies, family doctors should be:
(a) Educated in the science and clinical aspects of potential public health
emergencies, e.g. infection control during an influenza pandemic. In turn,
family doctors will be better informed to educate their patients and
members of the public within their communities of practice.
The College of Family Physicians of Canada
The Role of the Family Doctor in Public Health and Emergency Preparedness
December 2005
11
(b) Engaged in planning and implementing the response of the health care
system to public health emergencies, both locally and regionally.
(c) Assured of access to the required resources to support the care of their
patients during a public health emergency, including:
i. Communications (information management) from government and
health authorities;
ii. A hotline number to access information and obtain supplies as
required;
iii. Supplies such as masks and hand cleansers;
iv. Regularly updated procedures and protocols that are valid,
applicable, consistent and clear.
3. The health system should support adequate and sustained levels of integration and
collaboration between public health and primary care, including the sharing of
skills and knowledge between family doctors, other primary care providers and
community medicine specialists.
4. All governments and medical schools should continue to ensure the education and
training of sufficient numbers of family doctors to address both the primary care
and public health needs of Canadians. Every Canadian should be given the
opportunity to turn to his/her own family doctor as appropriate for the care
expected during a public health emergency.
5. All governments and health officials should work towards developing improved
tracking mechanisms that will help family doctors and other primary care
providers in determining the relative severity, intensity, location and subsequent
developments of public health emergencies. Building on its successful leadership
in a national primary care surveillance system, i.e. the FluWatch Program, the
CFPC welcomes opportunities to collaborate in the development of other public
health initiatives, including those being established through the Public Health
Network.
6. The CFPC should work with the PHAC and the CPHA to examine the roles of
primary care providers, especially family doctors, in responding to public health
emergencies and integrating their roles into existing emergency plans. The
creation of a task force supported by the PHAC’s Centre for Emergency
Preparedness should be considered.
7. As appropriate, the CFPC and its provincial Chapters should prepare the
necessary tools, resources and information to assist family doctors in responding
to a public health emergency such as a pandemic outbreak.
8. The CFPC should support effective and knowledgeable family doctor leaders in
creating networks of care between local community practices to ensure
communications and resources are provided as appropriate to the expectations of
local primary care practitioners.
The College of Family Physicians of Canada
The Role of the Family Doctor in Public Health and Emergency Preparedness
December 2005
12
9. The CFPC should continue to advocate on behalf of all family doctors in speaking
with governments, health authorities and Canadians to ensure the appropriate
involvement of family doctors in public health planning and implementation,
including health system responses during public health emergencies.
The College of Family Physicians of Canada
The Role of the Family Doctor in Public Health and Emergency Preparedness
December 2005
13
Endnotes
1. Government of Canada. Address by Prime Minister Paul Martin at the Meeting of
Ministers of Health on Global Pandemic Influenza Readiness. October 2005.
2. Dr. Barbara Starfield. “Public Health and Primary Care: A Framework for
Proposed Linkages” American Journal of Public Health. Vol. 86 No. 10, p. 1365
October 1996.
3. College of Family Physicians of Canada. Wait Times and Access to Care Decima
Poll Commissioned by the CFPC, November 2004
4. Canadian Medical Association. 3rd Annual National Report Card on Health Care,
p. 1 August 2003 and 5th Annual National Report Card on Health Care, p. 4
August 2005.
5. College of Family Physicians of Canada. Family Medicine in Canada: Vision for
the Future p. 16, November 2004.
6. Ibid, 37-38
The College of Family Physicians of Canada
The Role of the Family Doctor in Public Health and Emergency Preparedness
December 2005
14
Appendix A – Survey of Canadians
1. Do you, yourself, have a family doctor?
a. Yes 85%
b. No
15%
2. What do you believe the likelihood is that a city or region in Canada could face a
serious medical emergency, like a widespread flu outbreak, or a natural disaster,
such as a flood or earthquake, in the next three years?
a. Very likely
23%
b. Somewhat likely
45%
c. Not very likely
21%
d. Not likely at all
9%
3. To what degree do you believe the shortage of family physicians could impact the
ability of the health-care system to respond to the medical needs of Canadians
during an emergency, such as a widespread flu outbreak or a natural disaster?
a. Seriously impact
47%
b. Somewhat of an impact
36%
c. Not much impact
11%
d. No impact at all
3%
4. Based on your understanding of the situation, is it your perception that the various
levels of government are doing enough to ensure the healthcare system is
prepared to respond to an emergency, such as a widespread flu outbreak or natural
disaster?
a. Yes 31%
b. No
62%
5. In a time of emergency, such as during a widespread flu outbreak or natural
disaster, how important is it that you are able to turn to your family doctor’s office
for information and advice?
a. Very important
59%
b. Somewhat important
26%
c. Not very important
10%
d. Not important at all
3%
6. How important is it to you that family doctors in Canada have the ability to get
the information, equipment, supplies, and other supports, they would need in case
of a public health emergency?
a. Very important
82%
b. Somewhat important
14%
c. Not very important
2%
d. Not important at all
1%
The College of Family Physicians of Canada
The Role of the Family Doctor in Public Health and Emergency Preparedness
December 2005
15
7. Primary care professionals, including family doctors and nurses, should be closely
involved in the development of emergency plans for Canada because they are sure
to be on the frontlines if a public health emergency were to happen.
a. Strongly agree
67%
b. Somewhat agree
26%
c. Neither agree nor disagree 3%
d. Somewhat disagree
2%
e. Strongly disagree
1%
The survey of Canadians was conducted by Decima Research between October 13th and 24th of 2005. The
research is considered accurate +/- 2.2%, 19 times out of 20.
The College of Family Physicians of Canada
The Role of the Family Doctor in Public Health and Emergency Preparedness
December 2005
16
Appendix B – Survey on Family Doctor Confidence in the Public Health System
1. To what degree do you feel equipped in your practice today to handle a health
emergency, such as a pandemic flu outbreak or a natural disaster?
a. Very equipped
1%
b. Somewhat equipped 19%
c. Not very equipped
42%
d. Not equipped at all 29%
2. As a family doctor, what level of confidence do you have that in the case of a
regional or national emergency (e.g. outbreak or natural disaster), you will be able
to get the information, equipment, supplies, and personnel you need to provide the
level of care to your patients that they deserve?
a. Very confident
2%
b. Somewhat confident 24%
c. Not very confident 40%
d. Not confident at all 25%
3. As a family doctor faced with a pandemic flu outbreak or a natural disaster, if you
had the information, equipment, supplies, and personnel needed to help your
patients, would you feel sufficiently supported to care for your patients?
a. Yes
50%
b. No
11%
c. Don't know
31%
4. To what degree do you believe the shortage of family physicians could impact the
ability of the health-care system to respond to the medical needs of Canadians
during an emergency, such as a pandemic flu outbreak or a natural disaster?
a. Seriously impact
56%
b. Somewhat impact
29%
c. Not much impact
5%
d. No impact at all
1%
5. How satisfied are you that all levels of government are working well together to
ensure the health-care system is prepared to respond to an emergency, such as a
pandemic flu or natural disaster?
a. Very satisfied
4%
b. Somewhat satisfied
25%
c. Somewhat dissatisfied
32%
d. Very dissatisfied
21%
e. Don't know
10%
The survey of Family Physicians was conducted by the CFPC between October 17th and 31st of 2005. The
research is considered accurate +/- 3.7%, 19 times out of 20.
The College of Family Physicians of Canada
The Role of the Family Doctor in Public Health and Emergency Preparedness
December 2005
17
Contacts
Dr. Alain Pavilanis, President (term ends December 11th, 2005)
Dr. Louise Nasmith, President (term begins December 11th, 2005)
Dr. Calvin Gutkin, Executive Director and Chief Executive Officer
Dr. John Maxted, Director of Health Policy and Communications
Mr. Eric Mang, Health Policy Manager
The College of Family Physicians of Canada
2630 Skymark Avenue
Mississauga, ON L4W 5A4
Local telephone
Watts line
Fax
Email
905-629-0900
1-800-387-6197
905-629-0893
[email protected]
The College of Family Physicians of Canada
The Role of the Family Doctor in Public Health and Emergency Preparedness
December 2005
18
The College of Family Physicians of Canada (CFPC) strives to
improve the health of Canadians by:
• Ensuring the highest standards of training, certification, and
maintenance of proficiency for family physicians;
• Educating and informing the public about healthful living;
• Supporting research and disseminating knowledge; and
• Championing the rights of every Canadian to high-quality
health care.
Representing 17,000 family doctors across the country, the
CFPC is the collective voice of family medicine in Canada.
Its members are committed to the Four Principles of Family
Medicine:
• The patient-doctor relationship is central to all we do.
• Family physicians must be skilled clinicians.
• Family physicians should be a resource to a patient
population.
• Family medicine is a community-based discipline.
Role_Fam_Doc_Dec05.indd 2
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LE RÔLE DU MÉDECIN DE FAMILLE
en santé publique
et
capacité d’intervention en cas d’urgence
Document de réflexion
Décembre 2005
Siège Social/National Office
2630 avenue Skymark Avenue
Mississauga, Ontario, L4W 5A4
1.800.387.6197
téléc. 905.629.0893
www.cfpc.ca
Role_Fam_Doc_Dec05.indd 3
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Le Collège des Médecins de Famille du Canada (CMFC) s’efforce
d’améliorer la santé des Canadiens en:
• Assurant les normes les plus élevées de formation, de
certification et de maintien de la compétence pour les
médecins de famille;
• Informant et en éduquant la population aux habitudes de vie
saines;
• Soutenant la recherche, en diffusant les connaissances, et
• Protégeant les droits des Canadiens pour un accès à des
soins de santé d’une grande qualité.
Le CMFC, qui représente 17,000 médecins de famille répartis
aux quatre coins du pays, est la voix collective de la médecine
familiale au Canada. Ses membres endossent les quatre
principes de la médecine familiale:
• La relation médecin-patient est l’essence de tout ce que nous
faisons.
• Le médecin de famille doit être un clinicien compétent.
• Le médecin de famille devrait être une ressource pour une
population de patients.
• La médecine familiale est une discipline communautaire.
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